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	pageEncoding="ISO-8859-1"%>
<%@taglib prefix="s" uri="/struts-tags"%>
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<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=ISO-8859-1">
<title>Create a new Inquiry</title>

</head>
<body>

	<s:form id="addInquiryForm">
		<div class="header">Add Inquiry</div>
		<table class="formatTable" width="100%">
			<tr>
				<td>Inquiry Id</td>
				<td>:</td>
				<td>1</td>
				<td colspan="3"></td>
			</tr>
			<tr>
				<td>Inquiry Type</td>
				<td>:</td>
				<td><s:select list="inqTypeList" listKey="inqTypeId"
						listValue="inqTypeName" emptyOption="true" /></td>

				<td>Doctor Type</td>
				<td>:</td>
				<td><s:select list="doctTypeList" listKey="docttypeId"
						listValue="doctTypeName" emptyOption="true" /></td>
			</tr>
			<tr>
				<td>Doctor Name</td>
				<td>:</td>
				<td><input type="text" size="8"/></td>


				<td>Doctor Address</td>
				<td>:</td>
				<td>
					<table class="addressTable" cellpadding="0" cellspacing="0">
						<tr>
							<td><input type="text" /></td>
						</tr>
						<tr>
							<td><input type="text" /></td>
						</tr>
						<tr>
							<td><input type="text" /></td>
						</tr>
					</table>
				</td>
			</tr>
			<tr>
				<td>Hospital Name</td>
				<td>:</td>
				<td><input type="text" /></td>

				<td>Hospital Address</td>
				<td>:</td>

				<td><textarea></textarea></td>
			</tr>
			<tr>
				<td>Doctor Phone No.</td>
				<td>:</td>
				<td><input type="text" /></td>

				<td>Hospital Phone No.</td>
				<td>:</td>
				<td><input type="text" /></td>
			</tr>
			<tr>
				<td>Doctor Type</td>
				<td>:</td>
				<td><input type="text" /></td>

				<td>Brief Summary of Discussion</td>
				<td>:</td>
				<td><textarea></textarea></td>
			</tr>
			<tr>
				<td>Requirement of Model</td>
				<td>:</td>
				<td><s:select list="productsList" listKey="productId"
						listValue="productName" emptyOption="true" /></td>
				
				<td>Further Course of Action</td>
				<td>:</td>
				<td><textarea></textarea></td>
			</tr>
			<tr>
				<td>Date of Further Course of Action</td>
				<td>:</td>
				<td><input type="text" class="datePicker"/></td>
				
				<td colspan="3"></td>
			</tr>
			<tr>
				<td>Order Expected</td>
				<td>:</td>
				<td><input type="text" class="datePicker"/></td>
				
				<td>Further Course of Action</td>
				<td>:</td>
				<td><textarea></textarea></td>
			</tr>
			<tr>
				<td>Generated By</td>
				<td>:</td>
				<td><select></select></td>
				
				<td colspan="3"></td>
			</tr>
			<tr>
				<td>Order Expected</td>
				<td>:</td>
				<td><input type="text" class="datePicker"/></td>
				<td colspan="3"></td>
			</tr>
			<tr>
				<td>Initial Quote</td>
				<td>:</td>
				<td><input type="text"/></td>
				
				<td>Final Quote</td>
				<td>:</td>
				<td><input type="text"/></td>
			</tr>
			<tr>
			<td colspan="6"><br /></td>
			</tr>
			<tr>
				<td colspan="6" align="right">
				<input type="button" class="button" value="Save"/>				
				&nbsp;
				<input class="button" type="reset"/></td>
			</tr>
		</table>

	</s:form>

</body>
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